Is ERIE COUNTY SOUTH EAST CORP V flagged for Medicaid fraud?

ERIE COUNTY SOUTH EAST CORP V (NPI: 1487601837) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does ERIE COUNTY SOUTH EAST CORP V bill Medicaid?

ERIE COUNTY SOUTH EAST CORP V received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Community/Behavioral Health provider. Located in WEST SENECA, NY.

What is NPI 1487601837?

NPI 1487601837 is the National Provider Identifier for ERIE COUNTY SOUTH EAST CORP V. They are a Community/Behavioral Health provider based in WEST SENECA, NY. This NPI is registered with the CMS NPI Registry.

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ERIE COUNTY SOUTH EAST CORP V

Community/Behavioral Health·WEST SENECA, NY·NPI: 1487601837Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $94.4M is at the 50th percentile among 218 Community/Behavioral Health providers.

Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$94.4M

$94,380,871

Total Claims

817K

Beneficiaries

248K

3.3 claims/patient

Avg Cost/Claim

$115

Monthly Spending Trend

Yearly Spending

2018

$11.4M

+20%

2019

$13.6M

+12%

2020

$15.2M

-5%

2021

$14.5M

+7%

2022

$15.5M

+1%

2023

$15.5M

-44%

2024

$8.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (T1040 (Medicaid certified CCBHC services)) accounts for 90% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1040Medicaid certified CCBHC servicesSee all providers →

$85.4M

805K claims

$106.12

$130.29

0.8×

Normal range

T1040Normal range

Medicaid certified CCBHC services

$85.4M

805K claims · 90.5%

Your Cost: $106.12/claim|Median: $130.29

0.8× median

H0040Assertive community treatment, face-to-face, per 15 minutesSee all providers →

$6.0M

3,320 claims

$1,822.11

$266.41

6.8×

Top 10%

H0040Top 10%

Assertive community treatment, face-to-face, per 15 minutes

$6.0M

3,320 claims · 6.4%

Your Cost: $1,822.11/claim|Median: $266.41

6.8× median

H2016Comprehensive community support services, per 15 minSee all providers →

$1.7M

2,534 claims

$685.49

$321.53

2.1×

Normal range

H2016Normal range

Comprehensive community support services, per 15 min

$1.7M

2,534 claims · 1.8%

Your Cost: $685.49/claim|Median: $321.53

2.1× median

H2019Therapeutic behavioral services, per 15 minSee all providers →

$724K

1,213 claims

$596.47

$84.12

7.1×

Top 5%

H2019Top 5%

Therapeutic behavioral services, per 15 min

$724K

1,213 claims · 0.8%

Your Cost: $596.47/claim|Median: $84.12

7.1× median

90832Psychotherapy, 30 minutesSee all providers →

$250K

3,228 claims

$77.51

$41.28

1.9×

Top 25%

90832Top 25%

Psychotherapy, 30 minutes

$250K

3,228 claims · 0.3%

Your Cost: $77.51/claim|Median: $41.28

1.9× median

90834Psychotherapy, 45 minutesSee all providers →

$159K

1,616 claims

$98.20

$63.65

1.5×

Top 25%

90834Top 25%

Psychotherapy, 45 minutes

$159K

1,616 claims · 0.2%

Your Cost: $98.20/claim|Median: $63.65

1.5× median

90853Group psychotherapySee all providers →

$19K

350 claims

$55.60

$25.02

2.2×

Top 25%

90853Top 25%

Group psychotherapy

$19K

350 claims · 0.0%

Your Cost: $55.60/claim|Median: $25.02

2.2× median

99214Office/outpatient visit, est. patient, mod-high complexitySee all providers →

$17K

235 claims

$72.16

$53.41

1.4×

Normal range

99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$17K

235 claims · 0.0%

Your Cost: $72.16/claim|Median: $53.41

1.4× median

H2018Psychosocial rehabilitation services, per diemSee all providers →

$12K

39 claims

$296.28

$392.63

0.8×

Normal range

H2018Normal range

Psychosocial rehabilitation services, per diem

$12K

39 claims · 0.0%

Your Cost: $296.28/claim|Median: $392.63

0.8× median

H2011Crisis intervention service, per 15 minutesSee all providers →

$5K

65 claims

$80.24

$215.80

0.4×

Normal range

H2011Normal range

Crisis intervention service, per 15 minutes

$5K

65 claims · 0.0%

Your Cost: $80.24/claim|Median: $215.80

0.4× median

90791Psychiatric diagnostic evaluationSee all providers →

$2K

12 claims

$162.65

$99.21

1.6×

Top 25%

90791Top 25%

Psychiatric diagnostic evaluation

$2K

12 claims · 0.0%

Your Cost: $162.65/claim|Median: $99.21

1.6× median

99212Office/outpatient visit, low complexitySee all providers →

$2K

28 claims

$68.03

$25.06

2.7×

Top 10%

99212Top 10%

Office/outpatient visit, low complexity

$2K

28 claims · 0.0%

Your Cost: $68.03/claim|Median: $25.06

2.7× median

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